Acetylcholinesterase Inhibitors (AChEI's) for the treatment of visual hallucinations in schizophrenia: a review of the literature

Sachin S. Patel, Azizah Attard, Pamela Jacobsen, Sukhi Shergill

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Visual hallucinations occur in various neurological diseases, but are most prominent in Lewy body dementia, Parkinson's disease and schizophrenia. The lifetime prevalence of visual hallucinations in patients with schizophrenia is much more common than conventionally thought and ranges from 24% to 72%. Cortical acetylcholine (ACh) depletion has been associated with visual hallucinations; the level of depletion being related directly to the severity of the symptoms. Current understanding of neurobiological visual processing and research in diseases with reduced cholinergic function, suggests that AChEI's may prove beneficial in treating visual hallucinations. This offers the potential for targeted drug therapy of clinically symptomatic visual hallucinations in patients with schizophrenia using acetylcholinesterase inhibition. METHODS: A systematic review was carried out investigating the evidence for the effects of AChEI's in treating visual hallucinations in Schizophrenia. RESULTS: No evidence was found relating to the specific role of AChEI's in treating visual hallucinations in this patient group. DISCUSSION: Given the use of AChEI's in targeted, symptom specific treatment in other neuropsychiatric disorders, it is surprising to find no related literature in schizophrenia patients. The use of AChEI's in schizophrenia has investigated effects on cognition primarily with non cognitive effects measured more broadly. CONCLUSIONS: We would suggest that more focused research into the effects of AChEI's on positive symptoms of schizophrenia, specifically visual hallucinations, is needed.
Original languageEnglish
Article number69
JournalBMC Psychiatry
Volume10
DOIs
Publication statusPublished - 7 Sep 2010

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Hallucinations
Cholinesterase Inhibitors
Schizophrenia
Therapeutics
Lewy Body Disease
Acetylcholinesterase
Research
Cognition
Cholinergic Agents
Acetylcholine
Parkinson Disease
Drug Therapy

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Acetylcholinesterase Inhibitors (AChEI's) for the treatment of visual hallucinations in schizophrenia: a review of the literature. / Patel, Sachin S.; Attard, Azizah; Jacobsen, Pamela; Shergill, Sukhi.

In: BMC Psychiatry, Vol. 10, 69, 07.09.2010.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Visual hallucinations occur in various neurological diseases, but are most prominent in Lewy body dementia, Parkinson's disease and schizophrenia. The lifetime prevalence of visual hallucinations in patients with schizophrenia is much more common than conventionally thought and ranges from 24{\%} to 72{\%}. Cortical acetylcholine (ACh) depletion has been associated with visual hallucinations; the level of depletion being related directly to the severity of the symptoms. Current understanding of neurobiological visual processing and research in diseases with reduced cholinergic function, suggests that AChEI's may prove beneficial in treating visual hallucinations. This offers the potential for targeted drug therapy of clinically symptomatic visual hallucinations in patients with schizophrenia using acetylcholinesterase inhibition. METHODS: A systematic review was carried out investigating the evidence for the effects of AChEI's in treating visual hallucinations in Schizophrenia. RESULTS: No evidence was found relating to the specific role of AChEI's in treating visual hallucinations in this patient group. DISCUSSION: Given the use of AChEI's in targeted, symptom specific treatment in other neuropsychiatric disorders, it is surprising to find no related literature in schizophrenia patients. The use of AChEI's in schizophrenia has investigated effects on cognition primarily with non cognitive effects measured more broadly. CONCLUSIONS: We would suggest that more focused research into the effects of AChEI's on positive symptoms of schizophrenia, specifically visual hallucinations, is needed.",
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